Objective To explore the correlation between the nutritional and immunity score (NIS) based on prealbumin and T lymphocyte count and the prognosis of critically ill patients. Methods A retrospective study was conducted involving patients from the intensive care unit of the First Affiliated Hospital of Zhengzhou University from September 2020 to August 2021. Patients’ basic information, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores within 24 hours of admission, and relevant biochemical indicators were collected. The primary endpoint was all-cause mortality within 28 days. The optimal cut-off values for prealbumin and T lymphocyte count related to mortality risk were determined using X-tile software. Patients were stratified according to these cut-off values and normal reference ranges, and the NIS was calculated. Univariate and multivariate Cox regression analyses were conducted to evaluate the relationship between NIS and mortality. Results The optimal cut-off value for prealbumin was 110 mg/L, and for T lymphocyte count, it was 455/μL, with NIS scores ranging from 0 to 4. After adjusting for confounding factors, patients with NIS scores of 2 (HR＝1.87, 95%CI 1.19-2.94, P＝0.023), 3 (HR＝2.04, 95%CI 1.20-3.19, P＝0.007), and 4 (HR＝1.68, 95%CI 1.24-3.96, P＝0.005) showed a significantly increased risk of mortality. Conclusions NIS≥2 is associated with an increased risk of death in critically ill patients. NIS can serve as an effective tool for early risk stratification and prognostic assessment in critically ill patients.

Synthetic biology of traditional Chinese medicine (TCM) is a new and developing subject based on the research of secondary metabolite biosynthesis for nature products. The early development of synthetic biology focused on the screening and modification of parts or devices, and establishment of standardized device libraries. Panax notoginseng (Burk.) F.H.Chen is one of the most famous medicinal plants in Panax species. Triterpene saponins have important pharmacological activities in P. notoginseng. Squalene epoxidase (SE) has been considered as a key rate-limiting enzyme in biosynthetic pathways of triterpene saponins and phytosterols. SE acts as one of necessary devices for biosynthesis of triterpene saponins and phytosterols in vitro via synthetic biology approach. Here we cloned two genes encoding squalene epoxidase (PnSE1 and PnSE2) and analyzed the predict amino acid sequences by bioinformatic analysis. Further, we detected the gene expression profiling in different organs and the expression level of SEs in leaves elicited by methyl jasmonate (MeJA) treatment in 4-year-old P notoginseng using real-time quantitative PCR (real-time PCR). The study will provide a foundation for discovery and modification of devices in previous research by TCM synthetic biology. PnSE1 and PnSE2 encoded predicted proteins of 537 and 545 amino acids, respectively. Two amino acid sequences predicted from PnSEs shared strong similarity (79%), but were highly divergent in N-terminal regions (the first 70 amino acids). The genes expression profiling detected by real-time PCR, PnSE1 mRNA abundantly accumulated in all organs, especially in flower. PnSE2 was only weakly expressed and preferentially in flower. MeJA treatment enhanced the accumulation of PnSEI mRNA expression level in leaves, while there is no obvious enhancement of PnSE2 in same condition. Results indicated that the gene expressions of PnSE1 and PnSE2 were differently transcribed in four organs, and two PnSEs differently responded to MeJA stimuli. It was strongly suggested that PnSEs play different roles in secondary metabolite biosynthesis in P. notoginseng. PnSE1 might be involved in triterpenoid biosynthesis and PnSE2 might be involved in phytosterol biosynthesis.